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. 2023 Dec 20;40(4):e2023045.
doi: 10.36141/svdld.v40i4.14433.

Meta-analysis: clinical features and treatments of lung cancer in combined pulmonary fibrosis and emphysema

Jiayu Zhou  1 , Yu Jiang  2
Affiliations

Meta-analysis: clinical features and treatments of lung cancer in combined pulmonary fibrosis and emphysema

Jiayu Zhou et al. Sarcoidosis Vasc Diffuse Lung Dis. .

Abstract

Background and aim: There are many epidemiological pieces of evidence that show combined pulmonary fibrosis and emphysema (CPFE) patients have an increased risk of lung cancer. We conducted a systematic review of all published data to define the characteristics and treatments of lung cancer that develops in CPFE by performing a meta-analysis.

Methods: Databases(including PubMed, Medline, CNKI, VIP, etc.) were searched to find original articles that related to lung cancer in CPFE(CPFE-LC) patients and a meta-analysis was used to analyze the included 15 articles. Stata17.0 software was performed for this meta-analysis.

Results: Fifteen original studies that assessed 5933 patients were included in this meta-analysis. In the pooled data, people with CPFE-LC were elderly(70.58 years) and heavy smokers( 0.959, 45.793 pack-years), with a male predominance(0.959). Most lung cancer in CPFE was located in the lower lobe(0.533) and obvious areas of pulmonary fibrosis(0.516). Highest prevalence of cellular subtypes of lung cancer in CPFE was squamous carcinoma(SQCC, 0.437) and chemotherapy was the main treatment(0.387). The mortality rate was 0.720(95%CI: 0.657-0.783) and the 5-year survival rate was 0.250(95%CI: 0.133-0.368). The main cause of death was infection(0.268) and respiratory failure was the main cause of death after surgery(0.392).

Conclusions: Lung cancer in CPFE, most commonly SQCC, presents in elderly heavy smokers with a male, located in the lower lobe of the lung and the areas of fibrosis predominance. Chemotherapy is the main treatment and the optimal treatment remains to be explored.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangement, etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
A flow diagram of the study.
Figure 2.
Figure 2.
Forest plot for male patients in CPFE-LC.
Figure 3.
Figure 3.
Forest plot for FEV1 in the patients of CPFE-LC.
Figure 4.
Figure 4.
Forest plot for squamous carcinoma in the patients of CPFE-LC.
Figure 5.
Figure 5.
Forest plot for the tumor located in the lower lobe.
Figure 6.
Figure 6.
Forest plot for the comparison of pack-years.
Figure 7.
Figure 7.
Forest plot for chemotherapy.
Figure 8.
Figure 8.
Publication bias in the proportion of male patients.
See this image and copyright information in PMC

References

    1. Wiggins J, Strickland B, Turner-Warwick M. Combined cryptogenic fibrosing alveolitis and emphysema: the value of high resolution computed tomography in assessment. Respir Med. 1990;84(5):365–9. doi: 10.1016/s0954-6111(08)80070-4. - PubMed
    1. Cottin V, Nunes H, Brillet PY, et al. Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. Eur Respir J. 2005;26(4):586–93. doi: 10.1183/09031936.05.00021005. - PubMed
    1. Hirano ACG, Targueta EP, Ferraz de Campos FP, et al. Severe pulmonary hypertension due to combined pulmonary fibrosis and emphysema: another cause of death among smokers. Autops Case Rep. 2017;7(2):15–26. doi: 10.4322/acr.2017.022. - PMC - PubMed
    1. Cottin V, Cordier JF. Combined pulmonary fibrosis and emphysema in connective tissue disease. Curr Opin Pulm Med. 2012;18(5):418–27. doi: 10.1097/MCP.0b013e328356803b. - PubMed
    1. Roshan R, Guptal M, Kulshrestha R, Menon B, Chhabra SK. Combined pulmonary fibrosis and emphysema in a welder. Monaldi Arch Chest Dis. 2012;77(1):26–8. doi: 10.4081/monaldi.2012.164. - PubMed

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